In the meantime, there’s no sign that Washington DC will ease up on the “accomodative” money-printing presses that are feeding “QE Infinity.” That’s no problem, though, because Europe is reminding us that once the paper currency is undermined, selling gold is a handy way to quell grumpy voters and prop up the welfare state.

After reading the usual retail clinic policy tomes both for (“access to care”) and against (“health care balkanization” plus “missed diagnoses”), the Disease Management Care Blog isn’t convinced that Walgreens’ decision is such a slam dunk.

The good news for Walgreens is that they have Jeffrey Kang in their corner. Prior to this, he led health insurer CIGNA’s disease management initiatives. He undoubtedly understands retail, population-based outcomes and care coordination. If anyone can pull this off, he can.

The DMCB’s conclusions?

It won’t be easy. While Walgreens’ we-accept-all-insurance plans-VISA-Mastercard-and-American Express foray into primary care might work, it could also fail. Large health care systems use their primary care providers to feed their high margin and still-profitable specialty care services. On the other side, small physician-owned practices are learning that hustling, high service standards, attention to overhead, accurate billing, patient mix and ancillaries can be profitable. Walgreens has neither. It remains to be seen whether this publicly owned company’s bottom line will be aided by salaried NPs chasing pharmaceuticals’ narrowing margins.

Commoditization? The DMCB thinks so and it’s not alone. Over time, the professionals staffing these clinics may find primary care is more complex and that they and their patients deserve better.

Ease of Exit? For who? Given that this is ultimately a business, it would be corporate malfeasance if Walgreens didn’t have an exit strategy. Unfortunately, one company’s exit could be another patient’s abandonment. That’s a real risk for the patients who come to count on Walgreens for their longitudinal care.

Patient Centered Medical Home Threat… or Friend? The DMCB doesn’t think so. If the medical home offers the value that its advocates say, savvy health care consumers will be able to vote with their feet. If the PCMH falters, it won’t be because of Walgreens; in fact, the threat of competition may force help medical homes be more efficient. In the meantime, medical homes should treat retail clinics like a community resource and refer (or outsource) appropriate patients for routine health care. Why not?

About the Author

Jaan Sidorov MD is the Host of the Disease Management Care Blog where he shares his knowledge and insights about medical home, disease management, population-based health care and managed care.
He is a primary care internist and former Medical Director at Geisinger Health Plan with over 20 years experience in primary care, disease management and population-based care coordination. He is primary care by training, managed care by experience and population-based care strategies by disposition.
The contents of his blog reflect only his opinions and should not be interpreted to have anything to do with any current or past employers, clients, customers, friends, acquaintances or enemies, personal, professional, foreign or domestic.

I share your Walgreens skepticism. I recall two things standing out about their press release. One was that they would be able to diagnose people. And I am quite of the opinion that America does nto suffer from a shortage of diagnoses. And then they wrote that they would be willing to write prescriptions. I’m thinking, “how selfless of them!”

No, this isn’t albout market share. It’s a blatant attempt to simply expand the market for chronic disesae meds by finding more people with chronic disease mild enough to have previously been undetected to prescribe for, most of whom could have been better off with diet-and-exercise-and-lifestyle…and have insurors and employers pick up the tab.